Our Summary

This research paper is about a study comparing two types of surgical treatment methods for a condition known as two-level cervical degenerative disc disease (cDDD), a problem that affects the cushioning discs between the bones in the neck. Traditionally, a method known as anterior cervical discectomy and fusion (ACDF) using an anterior plate construct (APC) approach has been used. However, another method, also using ACDF but without a plate and instead using a locking stand-alone cage (LSC) approach, has become another option.

The researchers looked at data from nine previous studies involving a total of 687 patients who had the two-level ACDF surgery. They found that 44% of the surgeries used the LSC approach and 56% used the APC approach.

The findings showed that the LSC approach had a higher likelihood of a condition known as subsidence (which is when the height of the disc space decreases), and it also resulted in a larger disc height and reduced curvature of the neck. However, when it came to the success of the operation, the rate of the discs fusing together, the scores assessing the function of the neck, and the rates of difficulty swallowing after surgery, both methods were similar.

In conclusion, the study found that while there were some differences in the physical results between the two methods, there wasn’t one method that was clearly better than the other in terms of the overall outcomes for patients. The researchers suggest that larger studies with more patients and longer follow-up times are needed to confirm these findings.

FAQs

  1. What are the two surgical treatment methods compared in this study for two-level cervical degenerative disc disease?
  2. What differences were found between the LSC approach and the APC approach in terms of physical results and overall patient outcomes?
  3. What are the next steps researchers suggest to further investigate the effectiveness of these two surgical methods?

Doctor’s Tip

A helpful tip a doctor might tell a patient about discectomy is to carefully follow post-operative instructions, including restrictions on lifting, bending, and twisting to allow for proper healing of the spine. Physical therapy and regular exercise may also be recommended to help strengthen the muscles surrounding the spine and improve overall function. It’s important to communicate any concerns or changes in symptoms to your healthcare provider so they can monitor your progress and provide appropriate care.

Suitable For

Patients with two-level cervical degenerative disc disease (cDDD) who are experiencing symptoms such as neck pain, arm pain, weakness, numbness, and tingling may be recommended for discectomy surgery. Discectomy is typically recommended for patients who have not found relief from conservative treatments such as physical therapy, medications, and injections.

In the case of the study mentioned above, patients with two-level cDDD who were candidates for surgery were included in the research. These patients may have had symptoms such as neck and arm pain, weakness, and numbness due to compression of the spinal cord or nerves by the degenerated discs.

Overall, patients who are recommended for discectomy surgery are those who have not responded well to conservative treatments and are experiencing significant symptoms that impact their daily life and quality of life. It is important for patients to discuss with their healthcare provider to determine if discectomy surgery is the best option for their specific condition.

Timeline

Before the discectomy procedure, a patient may experience symptoms such as neck pain, arm pain, weakness, numbness, and tingling. They may undergo imaging tests such as MRI or CT scans to diagnose the condition and determine the best treatment option. The patient will then consult with a surgeon to discuss the surgical procedure, risks, benefits, and recovery process.

After the discectomy procedure, the patient will typically stay in the hospital for a few days for observation and pain management. They will be given instructions on post-operative care, including wound care, activity restrictions, and physical therapy. The patient may experience some pain and discomfort initially, but this should improve over time as they recover. Follow-up appointments will be scheduled to monitor the healing process and assess the success of the surgery.

What to Ask Your Doctor

Some questions a patient should ask their doctor about discectomy include:

  1. What are the potential risks and complications associated with the discectomy surgery?
  2. How long is the recovery process expected to take, and what can I do to help aid in my recovery?
  3. Will I need physical therapy or rehabilitation after the surgery, and if so, for how long?
  4. What are the expected outcomes of the surgery in terms of pain relief and function improvement?
  5. How will the choice between the APC and LSC approach impact my recovery and long-term results?
  6. Are there any specific factors about my condition that make one approach more suitable for me than the other?
  7. How experienced are you in performing the chosen surgical approach, and what is your success rate with this procedure?
  8. Are there any alternative treatment options to consider before proceeding with surgery?
  9. How often will I need follow-up appointments after the surgery, and what signs should I watch for that may indicate a complication?
  10. Are there any lifestyle changes or modifications I should make after the surgery to improve my outcomes?

Reference

Authors: Lu VM, Mobbs RJ, Fang B, Phan K. Journal: Eur Spine J. 2019 Jan;28(1):199-208. doi: 10.1007/s00586-018-5811-x. Epub 2018 Nov 2. PMID: 30390163